Tzivoni D
Bendheim Department of Cardiology, Jesselson Heart Center, Jerusalem, Israel.
Clin Cardiol. 2001 Feb;24(2):102-6. doi: 10.1002/clc.4960240202.
In recent years, much attention has been given to end organ protection by antihypertensive, anti-heart failure, and anti-ischemic medications. This review describes the available information on end organ protection by calcium-channel blockers (CCBs). In normotensive patients and patients with hypertension treated with long-acting dihydropyridines, medial thickness was thinner than in patients treated with atenolol or in untreated hypertensive patients. Long-term treatment was associated with significant reduction in left ventricular mass. Calcium-channel blockers also improved endothelial-dependent relaxation and reversed the vasoconstrictive response to nitric oxide inhibitors. In diabetic patients, CCBs were effective in preserving kidney function and microalbuminurea. The combination of angiotensin-converting enzyme (ACE) inhibitors and CCBs was more effective than ACE inhibitors alone in preserving kidney function. In animal experiments, CCBs prevented development of coronary atheroschlerosis; however, in humans only limited data are available on their antiatherogenic effect. Some studies suggest that CCBs exert antiplatelets properties and may therefore be beneficial in patients with coronary artery disease.
近年来，抗高血压、抗心力衰竭和抗缺血药物对终末器官的保护作用备受关注。本综述介绍了有关钙通道阻滞剂（CCB）对终末器官保护作用的现有信息。在血压正常的患者以及使用长效二氢吡啶类药物治疗的高血压患者中，血管中层厚度比使用阿替洛尔治疗的患者或未治疗的高血压患者更薄。长期治疗与左心室质量显著降低相关。钙通道阻滞剂还可改善内皮依赖性舒张功能，并逆转对一氧化氮抑制剂的血管收缩反应。在糖尿病患者中，CCB对保护肾功能和微量白蛋白尿有效。血管紧张素转换酶（ACE）抑制剂与CCB联合使用在保护肾功能方面比单独使用ACE抑制剂更有效。在动物实验中，CCB可预防冠状动脉粥样硬化的发展；然而，在人类中，关于其抗动脉粥样硬化作用的数据有限。一些研究表明，CCB具有抗血小板特性，因此可能对冠心病患者有益。
